1285900175 NPI number — MISS AWHINA MANEA ROBINSON LMP

Table of content: MISS AWHINA MANEA ROBINSON LMP (NPI 1285900175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285900175 NPI number — MISS AWHINA MANEA ROBINSON LMP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
AWHINA
Provider Middle Name:
MANEA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LMP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285900175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9505 BRIDGE RD SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YELM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98597-9640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-458-4350
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
284 LEE ST SW
Provider Second Line Business Practice Location Address:
SUITE 128
Provider Business Practice Location Address City Name:
TUMWATER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98501-4403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-489-0469
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  60275813 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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